Pneumatic Compressor/Lymphedema Pump Coding Chart Update

The following is a list of pneumatic compressor/lymphedema pump-assigned HCPCS codes to be used when submitting claims to the DMERC. The appearance of a HCPCS code does not necessarily indicate coverage.

Manufacturer/Brand Name	Model Name/No.	HCPCS Code
Advantage	2100	E0652
Bio Compressions Systems/ Sequential Circulator 2000	2000	E0651
	2004	E0651
	3000	E0652
	3001	E0652
3004	E0651
Camp	GCS 2000	E0652
Chattanooga	PresSsion	E0651
	PresSsion 4328 CGS	E0651
	PresSsion 4330 VGS	E0652
	4320	E0650
	4322	E0650
Huntleigh	Flowplus (AC330)	E0650
	Flowpress (AC300)	E0651
	Flowtron	E0650
	Lymphatron	E0650
	Lymphatron (AC340)	E0651
	Lymphatron Trio (AC350)	E0652
Jobst/Extremity Pump	Clinical Model	E0650
	System 7000	E0650
	System 7500 (II)	E0651
Kendall	Home Rx (5550)	E0651
Mago Afek/Lymph Press	103A	E0651
	103M	E0652
	201 A-Mini	E0651
	201-M	E0652
MedComp	MC 5 Gradient Sequential	E0652
Ormed	Lympha-Mat Digital	E0651
	Lympha-Mat 300	E0651
	Vasoflow 100	E0651
	Vasoflow 200	E0652
Talley/Hemaflovy 2 Pump	Intermittent	E0650
	Sequential	E0651
Talley/Multicom	100	E0650
	200	E0650
	300	E0651
	300G	E0652
	500 ('93 and '94 model)	E0652 *
Talley/Multipulse	1000	E0652
Thera-Con	Thera-flow	E0652
	651 SERIES	E0651
Wright Linear Pump	II	E0652
Wright Linear Pump	IV	E0652
*Talley/Multipulse model '92 or before uses code E0651